From the Guidelines
Flashes of light in the eyes, also known as photopsias, are a symptom of posterior vitreous detachment (PVD) that can lead to retinal breaks and detachment, and patients experiencing such symptoms are at a higher risk for retinal detachment. These flashes are often described as brief flashes or sparkles of light in your vision that occur without an external light source, and are likely the result of vitreous traction on the retina as the vitreous separates from the posterior retina toward the vitreous base 1. Some common characteristics of photopsias include:
- Being most noticeable in the dark
- Resulting from vitreous traction on the retina
- Possibly being accompanied by floaters (myodesopias) due to blood from a torn or avulsed retinal vessel, condensations of vitreous collagen, or the epipapillary glial tissue (Weiss ring) that is torn from the optic nerve head and area adjacent to the optic nerve head 1. It is essential to seek immediate medical attention from an eye care professional if you experience frequent, persistent, or increasing flashes, especially accompanied by other visual disturbances, as this could indicate a more serious condition such as retinal detachment or ocular migraine. According to the study published in Ophthalmology in 2020, between 8% and 22% of patients with acute PVD symptoms have a retinal tear at the time of the initial examination, and patients with an acute PVD who have no reported retinal breaks on presentation have a 2% to 5% chance of experiencing a detected (missed or new) break in the weeks that follow 1. Therefore, it is crucial to be aware of any changes in your vision and consult a doctor if you're concerned or if the flashes are accompanied by vision loss, eye pain, or a sudden increase in floaters.
From the Research
Definition and Causes of Photopsia
- Photopsia, also known as flashes of light in the eyes, is a relatively common symptom reported by patients in primary eye care settings 2.
- It is usually associated with one of the following conditions: posterior vitreous detachment, migraine with aura, migraine aura without headache, and retinal break or detachment 2.
- Spontaneous posterior vitreous detachment (PVD) can cause the onset of symptoms that include visual disturbances, myodesopsia, and photopsia 3.
Relationship between Photopsia and Posterior Vitreous Detachment
- The prevalence of posterior vitreous detachment was significantly higher in eyes with floaters and light flashes than in asymptomatic eyes 4.
- The prevalence of retinal breaks in eyes with posterior vitreous detachment was higher in eyes with floaters and light flashes than in asymptomatic eyes 4.
- Photopsia can be a symptom of posterior reversible encephalopathy syndrome (PRES), which is associated with several symptoms, including visual acuity loss, light oversensitivity, and light flashes 5.
Other Possible Causes of Photopsia
- Topiramate, an antiepileptic drug, can cause ocular side effects, including photosensitivity, which is a sensitivity to light 6.
- Migraine with aura and migraine aura without headache can also cause photopsia 2.
- Retinal break or detachment can cause photopsia, and it is essential to diagnose and treat these conditions promptly to prevent irreversible sight-threatening complications 2, 3.